Legal status defines immigrants' health reform benefits

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SEATTLE (AP) - For immigrants living in the country illegally, the new health care coverage under President Barack Obama's Affordable Care Act will be simple: They don't get any. In Washington state, however, some of those immigrants can still qualify for certain already-existing state health programs.

Both immigrants legally in the country and those illegally here who qualify for state programs will be able to look up their eligibility through the web portal created by the Washington Health Benefit Exchange.

Those are a few nuggets of information in often-confusing health care facts the exchange is tasked with diffusing among minority populations in the state before enrollment begins on Oct. 1 for the expanded marketplace of health insurances.

"We have to make sure 6.5 million people are aware of what's happening," said Michael Marchand, communications director for the exchange.

According to U.S. Census figures, nearly half a million Washington residents over age 5 speak a language other than English and say they don't speak English very well. More than 200,000 say Spanish is their primary language, but another 150,000 say they speak an Asian or Pacific Islander language.

In all, people in Washington who don't speak English well speak more than 150 different languages, not including dialects, according to the Census.

State officials estimate about 1 million Washington residents are uninsured, or about one in seven people who live in the state. About a third of them will likely become eligible for free health insurance under the expanded Medicaid. The rest will be targeted by the state's new health insurance exchange.

So far, the agency has had some stumbling steps.

Their efforts to translate information pages on their website had to be scrapped after it was revealed by a public radio report that slang and unprofessional language was used in some of them. Some advocates have also raised questions on requiring a bank account to pay for the services - the population without bank accounts in the state is estimated to be high among immigrants and minority populations.

But with three weeks to go before enrollment, an advertising blitz has already begun, and earlier this summer, the exchange posted a chart showing immigrant eligibility. The exchange's community partners were also vetted to make sure they could communicate in foreign languages present in their region, Marchand said.

Refugees and people who apply for asylum qualify for the expanded insurance marketplace provided by the exchange. Lawful permanent residents qualify for the expanded insurance marketplace provided by the exchange as well. Refugees, people awaiting asylum and other immigrants legally in the county may qualify for Medicaid, but it depends on their circumstances.

Some immigrants living in the country illegally have some options: Children under 18 and pregnant women can qualify for Washington's Apple Health, an umbrella program that uses state and federal funds to operate. Although federal money does not go to pay for those immigrant's health needs, state officials say.

Young immigrants under a temporary permit under Obama's Deferred Action for Childhood Arrivals don't qualify for the expanded marketplace, as well.

Among the immigrant population, one of the key obstacles is translating the glossary of health terms that can even be confusing in English. Literal translations, Marchand said, don't work. The information pages that were scrapped recently are being re-worked and after the contractor finishes the translations, the exchange will have outside groups review the information.

Another source of information for Washington residents will be the call center set up in Spokane. Marchand said there will be seven staffers on-site that can speak Spanish. The call center will also contract out with a national language line to field inquiries in other languages. Should that fail, Marchand said the call center will attempt to find a person capable of translating among the community partners in the region.

The exchange and advocates are still figuring out how to accommodate people who don't have bank accounts. Estimates from advocacy groups suggest that around a quarter of people currently uninsured, which is roughly 1 million Washington residents, don't have a bank account.

While there aren't Washington state surveys, national studies suggest African Americans and Latinos are 40 percent likelier to not have a bank account, according to Jackson Hewitt Tax Service Inc. study. Marchand said the exchange is weighing solutions, such as pre-paid debit cards.